A prospective randomised study comparing intravenous magnesium sulphate and sublingual nitroglycerine spray in attenuating haemodynamic responses to laryngoscopy and intubation

Abstract

<p class="abstract"><strong>Background:</strong> Laryngoscopy and tracheal Intubation are invariably associated with certain stress responses due to the sympatho-adrenal stimulation. These cardiovascular and neurohumoral alterations may directly affect the physiology and increase the risk. So far, various drugs have been tried but none has been considered ideal for blunting this presser response. We therefore, planned this comparative study to evaluate and compare the efficacy of intravenous magnesium sulphate (30 mg/kg) versus sublingual nitroglycerine spray (0.4 mg/spray) in attenuating the presser response to Laryngoscopy and Tracheal Intubation.</p><p class="abstract"><strong>Methods:</strong> Fifty patients, aged 15–50 years, scheduled for elective surgery under general anaesthesia, were randomly assigned to one of the two groups of 25 each, Group A (magnesium group) and Group B<strong> </strong>(nitroglycerine group). Study drug was given 90-120 seconds before tracheal intubation. Heart rate, Systolic blood pressure and Rate pressure product were recorded at different intervals after administering the study drug till 3 minutes after intubation.</p><p class="abstract"><strong>Results:</strong> Mean heart rate was significantly higher from the baseline at all times after administering the study drug in both the groups. Increase in systolic blood pressure as a presser response was limited to 7.25% in Group A and 5.83% in Group B from the baseline after tracheal intubation. There was relative hypotension after administration of the study drug in both the groups.</p><p class="abstract"><strong>Conclusions: </strong>Intravenous magnesium or sublingual nitroglycerine pre-treatment is found to be effective in attenuating the presser response to laryngoscopy and intubation. These drugs may lead to rise in HR but it is transient and dose dependent. However, both the drugs can significantly control the hypertensive response after laryngoscopy and intubation.</p><p class="abstract"> </p>

Effect of single bolus dose of intravenous magnesium sulfate in attenuating hemodynamic stress response to laryngoscopy and nasotracheal intubation in maxillofacial surgeries

“…7 Other effects are arrhythmias and an increase in intracranial pressure. Many pharmacological agents have been used to attenuate this stress response such as Fentanyl, 8 Esmolol, 9 intravenous lignocaine, 10 Dexmedetomidine, 11 Nitroglycerine, 12 oral Pregabalin, 13 and oral Gabapentine. 13 Catecholamine release from adrenergic nerve endings and adrenal medulla is inhibited by magnesium sulfate thereby attenuating stress response.…”

Levels of serum Hoxb3 and sFlt‐1 in pre‐eclamptic patients and their effects on pregnancy outcomes

“…It may lead to serious maternal complications as well as fetal and neonatal poor perinatal outcomes, such as cardiovascular diseases, fetal intrauterine growth restriction, low birthweight and stillbirth 3–5 . For pre‐eclampsia parturient, it is clinically recommended to use drugs to control maternal convulsions and blood pressure, and for some severe cases, it is recommended to terminate pregnancy 6 . Therefore, it is particularly important for the prevention of eclampsia.…”